Dear Colleagues,
On a slightly different theme, our policy is to refer samples with a
globulin of >37g/L (and normal LFT and no history of Rheumatoid) for
electrophoresis.
We recently analysed 2 years data with respect to the numbers of unsuspected
paraproteins that were detected using these criteria and compared these
numbers with the numbers detected on the basis of clinical suspicion i.e the
clinicians rather than the lab making the request.
The results were striking:-
74% of all newly discovered paraproteins were detected by the lab making the
request.
Regards,
Ian Barlow
Principal Biochemist
Scunthorpe,
UK
> -----Original Message-----
> From: R.W. Wulkan [SMTP:[log in to unmask]]
> Sent: Thursday, January 06, 2000 1:36 PM
> To: [log in to unmask]
> Cc: [log in to unmask]
> Subject: protein electrophoresis
>
> Dear collegues,
>
> We took the trouble to verify Trevors rule of (TP-Alb)> 37 g/L
> (serum) on 100 consecutive protein electrophoresis patterns.
> Results are:
>
> >37 g/L 12 with M comp., 20 without
> =< 37 g/L 4 with M-comp., 64 without
>
> The concentrations were <2, <2, 5 and 3 g/L on the 4 patients
> that would have been "missed".
> Our total protein method is biureet, the albumin is BCP.
> Unknown to us is how many samples would have been signalled
> routinely. We have a rather large rheumatology centre lots of acute
> phase reactions. Another argument for debate could be that
> sometimes the psychosocial condition of the patient makes it
> undesirable to pursue further illness. We think that this is the
> docters decision. As an intermediate solution you could agree to
> sinal TP-Alb > 37 g/L as such, without automatic electrophoresis.
>
>
> Best regards,
>
> Raymond Wulkan
> Zuiderziekenhuis
> Rotterdam-NL
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